干眼症症状与体征的相关性研究

Study on correlation of symptoms and signs in dry eye patients

目的分析干眼症患者的主观症状与客观检查的相关性。方法选取2007年12月—2008年8月就诊于天津医科大学眼科中心门诊的干眼症患者126例252眼,检查前均取得患者书面同意。通过检查视力、泪膜干涉仪检查、泪液分泌试验(STⅠ)、干眼症问卷调查,并在15min后用裂隙灯检查眼前节,进行泪膜破裂时间(BUT)及荧光素(FL)染色检查。采用Spearman秩相关研究分析干眼症症状与体征间的关系。结果干眼症患者最常见的症状是视疲劳(85.7%)、干涩(75.4%)、视力波动(73.8%)、眼痒(65.9%)以及异物感(66.7%)。干眼症患者分泌物增多与STⅠ呈正相关(r=0.208,P=0.020),流泪症状与STⅠ结果呈正相关(r=0.311,P=0.000),眼痛与BUT呈负相关(r=-0.197,P=0.027),眼红与FL染色呈正相关(r=0.227,P=0.011),异物感与FL染色呈正相关(r=0.251,P=0.005)。其余干眼症症状与ST、BUT、FL染色无明显相关性(P>0.05),所有干眼症症状均与泪膜干涉图像分级无明显相关(P>0.05)。结论干眼症患者症状复杂,干眼症症状与体征的相关性较差。

Background Dry eye is a ocular surface disease with different degrees of symptom and physical signs.Objective The purpose of this study was to analyze the correlation between the subjective symptom and objective clinical signs in dry eye patients.Methods A total of 252 eyes of 126 dry eye patients diagnosed in Tianjin Medical University Eye Center were recruited in this study from December 2007 to August 2008.A series of relevant examinations,including visual acuity,tear film interferometer inspection,Schirmer test Ⅰ,dry eye questionnaire,anterior segment manifestation under the slit lamp,tear film break-up time,and fluorescein staining were performed in all the patients.The correlation of dry eye tests with symptoms were evaluated by using Spearman rank correlation coefficients.The researchers received the standardizing training for this survey.Written informed consent was obtained form each patient before any medical protocol.Results Frequency distribution of sign of dry eye showed that the asthenopia （85.7%） was a most prominent symptom and others,in turn,was aningeresting（75.4%）,vision fluctuate（73.8%）,eye itch （65.9%） and foreign body sensation （66.7%）.The Spearman correlation analysis indicated that the positive correlation was shown between the amount of ocular secretions and Schirmer test Ⅰ （r=0.208,P=0.020）,tearing and Schirmer test Ⅰ （r=0.311,P=0.000）,foreign body sensation and grade of fluorescein staining（r=0.251,P=0.005）,eye redness and grade of fluorescein staining （r=0.227,P=0.011）.The negative correlations were found between eye pain and tear break-up time（r=-0.197,P=0.027）.Besides,the results of the tear interference images were not associated with dry eye symptom （P0.05）.Conclusion The result from this study demonstrate that dry eye symptoms and signs are poorly correlated.